Topiramate oral tablet interactions: A detailed guide

This article describes possible interactions with topiramate oral tablet. Interactions can cause a drug to have a different effect on the body than expected. Interactions can occur due to medications, alcohol, or certain health conditions.

Topiramate also comes as an oral capsule, extended-release oral capsule, and an oral liquid solution. (With extended-release, the drug is released slowly in your body over time.) Brand name versions of topiramate include Topamax, Qudexy XR, Trokendi XR, and Eprontia. Interactions of topiramate are the same for different forms of the drug.

Other drugs and topiramate

The drugs in the list below may interact with topiramate oral tablet. This article doesn’t include all drugs that may interact with topiramate.

Drug classes or drugs that may interact with topiramate oral tablet include:

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Health factors and topiramate

Certain medical conditions or other health factors may increase the risk of interactions with topiramate oral tablet. Keep in mind that interactions could lead to side effects or affect how well the drug works. Before taking topiramate, tell your doctor about your health history. They’ll discuss any topiramate warnings and determine whether topiramate is right for you.

These health conditions or other factors might interact with topiramate oral tablet:

• eye conditions, such as glaucoma
• lung or breathing conditions
• kidney or liver conditions
• osteoporosis or weak bones
• severe or frequent diarrhea
• past mental health conditions or suicidal thoughts
• pregnancy or breastfeeding
• past allergic reaction to topiramate
• ketogenic diet (diet high in fat and low in carbohydrates)*

* For more details about topiramate and the ketogenic diet, see the “Other interactions and topiramate” section below.

Suicide prevention

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

• Call the 988 Suicide and Crisis Lifeline at 988.
• Text HOME to the Crisis Textline at 741741.
• Not in the United States? Find a helpline in your country with Befrienders Worldwide.
• Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you are not in the same household, stay on the phone with them until help arrives.

When to avoid topiramate

Certain health conditions or other factors could increase some risks with topiramate oral tablet. To learn more about these factors and other topiramate warnings, see the “Health factors and topiramate” section above.

Topiramate doesn’t have any contraindications. These are cases in which doctors may not prescribe topiramate.

Talk with your doctor or pharmacist if you have questions about when to avoid topiramate.

Other interactions and topiramate

Interactions can occur with supplements, foods, vaccines, and some lab tests. Below you can learn whether topiramate oral tablet has these interactions.

The information below doesn’t include all other possible interactions with topiramate.

Topiramate and food

Topiramate can interact with a ketogenic diet (a diet high in fats and low in carbohydrates). Following a ketogenic diet while taking topiramate can raise your risk of metabolic acidosis (high level of acid in your blood).

Because of this, if you follow a ketogenic diet you should talk with your doctor before you start taking topiramate. If you’re already taking topiramate, talk with your doctor if you want to try this type of diet.

Topiramate isn’t known to interact with specific foods. But this doesn’t mean interactions can’t happen or won’t be identified later.

If you have questions about specific foods to avoid while taking topiramate oral tablet, talk with your doctor or pharmacist.

Topiramate and supplements

Before taking topiramate oral tablet, tell your doctor and pharmacist about any herbs you take, as well as vitamins and supplements. Doing so may help you avoid interactions.

If you have questions about interactions that may affect you, talk with your doctor or pharmacist.

Topiramate interactions with vitamins

Topiramate oral tablet isn’t known to interact with any vitamins. But this doesn’t mean interactions with vitamins can’t happen or won’t be identified later.

Because of this, ask your doctor or pharmacist before using any of these products while taking topiramate oral tablet.

Topiramate and herbs

Topiramate oral tablet isn’t known to interact with any herbs. But this doesn’t mean interactions with herbs can’t happen or won’t be identified later.

Because of this, ask your doctor or pharmacist before using any of these products while taking topiramate oral tablet.

Topiramate and vaccines

Topiramate oral tablet isn’t known to interact with any vaccines. But this doesn’t mean interactions with vaccines can’t happen or won’t be identified later.

Because of this, talk with your doctor or pharmacist before receiving any vaccines while taking topiramate oral tablet.

Topiramate and lab tests

Topiramate oral tablet isn’t known to interact with lab tests. But this doesn’t mean interactions with lab tests can’t happen or won’t be identified later.

Because of this, talk with your doctor or pharmacist before having any tests while taking topiramate oral tablet.

Topiramate and cannabis or CBD

Topiramate oral tablet isn’t known to interact with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But this doesn’t mean interactions can’t happen or won’t be identified later.

For example, both topiramate and cannabis can cause sleepiness and difficulty concentrating. So you may have an increased risk of these side effects if you use cannabis with topiramate.

As with any drug or supplement, talk with your doctor before using cannabis with topiramate.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Alcohol and topiramate

Topiramate oral tablet has interactions with alcohol.

Taking topiramate oral tablet and drinking alcohol may cause:

• sleepiness
• dizziness
• confusion
• difficulty concentrating
• slowed breathing
• loss of consciousness
• coma

You should avoid drinking alcohol with topiramate. If you drink alcohol and have concerns about avoiding it while taking topiramate oral tablet, talk with your doctor.

Preventing topiramate interactions

You may be able to help avoid certain interactions with topiramate oral tablet. Before taking this drug, you may want to discuss possible interactions with your doctor and pharmacist.

Things to consider include:

• Whether you drink alcohol or use cannabis.
• Other medications and herbs you take, as well as vitamins and supplements. Your doctor or pharmacist can help you fill out a medication list.
• What to do if you’re prescribed a new drug while taking topiramate oral tablet.

Taking topiramate exactly as prescribed can also help prevent interactions.

What to ask your doctor

If you have questions about topiramate and possible interactions, talk with your doctor.

Questions you may want to ask your doctor include:

• Does topiramate interact with other drugs I take for migraine or seizures?
• Does my risk of interactions depend on my dosage of topiramate?
• Do other drugs that could treat my condition have similar interactions?
• What forms of birth control don’t interact with topiramate?

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.